Chen Lin, Zheng Jing, Kong Dong, Yang Lijuan
Nursing Department, Shandong Provincial Hospital, Jinan, Shandong, China.
Cardiac Surgical Intensive Care Unit, Shandong Provincial Hospital, Jinan, Shandong, China.
Asian Nurs Res (Korean Soc Nurs Sci). 2020 Feb;14(1):44-49. doi: 10.1016/j.anr.2020.01.004. Epub 2020 Jan 22.
Enhanced recovery after surgery (ERAS) is an evidence-based perioperative measure to improve outcomes. Although the benefits of ERAS are well proven for other surgeries, little is known about its effect on off-pump coronary artery bypass graft (OPCABG) surgery. Thus, this study aimed to explore the effect of an ERAS protocol in patients who underwent OPCABG surgery.
This quasi-experimental study included 94 participants (traditional care group = 47 vs ERAS group = 47). An ERAS protocol was established by a multidisciplinary team. Knowledge of coronary artery disease, fasting time, water deprivation time, extubation time of the tracheal tube and pericardial and mediastinal drainage tube, off-bed activity participation rate, length of hospital stay, hours of intensive care unit (ICU) stay, expenses in ICU, incidence rates of ICU delirium and postoperative nausea and vomiting, and the 6-Minute Walk Test on postoperative day 7 were recorded and calculated between the groups.
Demographics, lifestyle, and disease severity showed no significant difference between the two groups (p > .05). The ERAS group patients had improved understanding of coronary artery disease (t = -3.89, p < .01), shorter fasting time (t = 7.98, p < .01), shorter water deprivation time (t = 9.29, p < .01), increased off-bed activity participation (t = 17.67, p < .01), and the improved 6-Minute Walk Test on postoperative day 7 (t = -3.23, p < .01).
The ERAS protocol is safe and effective for patients undergoing OPCABG surgery.
术后加速康复（ERAS）是一种基于证据的围手术期措施，旨在改善手术结局。尽管ERAS对其他手术的益处已得到充分证实，但对于其在非体外循环冠状动脉搭桥术（OPCABG）中的作用知之甚少。因此，本研究旨在探讨ERAS方案对接受OPCABG手术患者的影响。
本准实验研究纳入了94名参与者（传统护理组 = 47名，ERAS组 = 47名）。由多学科团队制定了ERAS方案。记录并计算两组患者的冠心病知识、禁食时间、禁水时间、气管导管及心包和纵隔引流管拔除时间、离床活动参与率、住院时间、重症监护病房（ICU）住院时长、ICU费用、ICU谵妄及术后恶心呕吐的发生率，以及术后第7天的6分钟步行试验结果。
两组患者的人口统计学、生活方式和疾病严重程度无显著差异（p > .05）。ERAS组患者对冠心病的了解有所改善（t = -3.89，p < .01），禁食时间缩短（t = 7.98，p < .01），禁水时间缩短（t = 9.29，p < .01），离床活动参与度增加（t = 17.67，p < .01），且术后第7天的6分钟步行试验结果有所改善（t = -3.23，p < .01）。
ERAS方案对接受OPCABG手术的患者安全有效。
